Transient neurological deficits mimicking left middle cerebral artery infarct after carotid artery stenting without associated imaging findings: A case report

• Main Authors: Melek Kandemir, M. Savas Tepe, Betul Yalciner
• Format: Article
• Language: English
• Published: Turkish Society of Cerebrovascular Diseases 2017-08-01
• Series: Türk Beyin Damar Hastalıkları Dergisi
• Subjects: Carotid artery stenting; transient neurological deficit; blood–brain barrier; reversible vasoparalysis; contrast agent
• Online Access: https://dx.doi.org/10.5505/tbdhd.2017.42275

Various complications have been reported after carotid artery stenting. Ischemic lesions and hyperperfusion syndrome are well-known complications, and new cerebral microembolic lesions detected via diffusion-weighted imaging are observed in almost all patients. We describe a case who developed transient neurological deficits immediately after stenting without additional imaging findings. A 64-year-old male underwent carotid artery stenting complicated by transient neurological deficits mimicking a left middle cerebral artery infarction. The complication occurred immediately after stenting, but the symptoms resolved within less than 48 h. Magnetic resonance imaging findings showed no signs of a new infarct, no hemorrhage, and no high signal intensity in the meninges. We conclude that the most likely pathogenesis of this complication was vasogenic edema because of vasoparalysis of the local vessels, resulting from hemodynamic changes occurring after stenting and/or biochemical effects of repeated contrast agent administration.